Frick S, Jung K, Rückert K
Dtsch Med Wochenschr. 1987 Apr 17;112(16):629-35. doi: 10.1055/s-2008-1068110.
From 1966 to 1985, 994 patients were treated for chronic pancreatitis. In 339 (34%), a resection of the pancreas was carried out. There were 166 left resections as compared to 175 right resections (Whipple, total duodenopancreatectomy). Almost half of the patients had already been operated on beforehand. The surgical lethality after partial duodenopancreatectomy could be lowered from 15% to 1.6%. After left resection, it continued without change to be 4% to 7%. Total duodenopancreatectomy and subtotal left resection were no longer carried out. 31% of the 246 patients followed up in a retrospective study died in the later course (mean period of follow-up observation: 6.5 years). Less than 10% of the patients died of complications due to pancreatitis. Three quarters of the patients maintained constant weight or gained weight. In half of the patients, there was a manifest diabetes mellitus postoperatively. 76% were free of pain postoperatively or had only slight symptoms. The late results are essentially determined by the readiness of the patients to adopt a disciplined style of life with reduction of alcohol consumption. This must be considered in the establishment of the indication for pancreatectomy in chronic pancreatitis.
1966年至1985年期间，994例慢性胰腺炎患者接受了治疗。其中339例（34%）实施了胰腺切除术。左半胰腺切除术166例，右半胰腺切除术（惠普尔手术，即全胰十二指肠切除术）175例。几乎半数患者此前已接受过手术。部分胰十二指肠切除术后的手术死亡率从15%降至1.6%。左半胰腺切除术后，死亡率持续保持在4%至7%不变。全胰十二指肠切除术和左半胰腺次全切除术不再实施。在一项回顾性研究中随访的246例患者中，31%在后期病程中死亡（平均随访观察期：6.5年）。不到10%的患者死于胰腺炎相关并发症。四分之三的患者体重维持稳定或有所增加。半数患者术后出现明显的糖尿病。76%的患者术后无痛或仅有轻微症状。后期结果主要取决于患者是否愿意采取自律的生活方式并减少酒精摄入。在确定慢性胰腺炎胰腺切除术的指征时必须考虑这一点。
